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Surgical Treatment of Perianal Fistulizing Crohn’s Disease: From Lay-Open to Cell-Based Therapy—An Overview
Joint Authors
Pellino, Gianluca
Selvaggi, Francesco
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-11-06
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Medicine
Information Technology and Computer Science
Abstract EN
Background.
Perianal Crohn’s disease (CD) can be challenging.
Despite the high incidence of fistulizing CD, literature lacks clear guidelines.
Several medical, surgical, and combined treatment modalities have been proposed, but evidences are scarce.
Methods.
We searched the literature to assess the facets of perianal CD, with particular focus on complex fistulae.
Disease epidemiology, classification, diagnosis, activity scoring systems, and medical-surgical treatments were assessed.
Results.
Perianal fistulizing CD is common, frequently associated with upper gastrointestinal and colorectal CD.
Complex fistulas often require repeated treatments.
Continence is a major concern when dealing with repeated procedures.
A prudent pathway is to resolve active sepsis and to limit damages, delaying a definitive treatment to the time when acute phase has been controlled.
The improved diagnostic techniques allow better preoperative planning and are useful in monitoring the response to treatment.
Besides newer devices, cell-based treatments are promising tools which have recently enriched the treatment portfolio.
However, the need for proctectomy is still disturbingly high in CD patients with complex perianal fistulae.
Conclusions.
Perianal CD can impair quality of life and lead to need for proctectomy.
A staged approach is reasonable.
Treatment success can be improved by multimodal treatment and collaborative management by experienced gastroenterologists and surgeons.
American Psychological Association (APA)
Pellino, Gianluca& Selvaggi, Francesco. 2014. Surgical Treatment of Perianal Fistulizing Crohn’s Disease: From Lay-Open to Cell-Based Therapy—An Overview. The Scientific World Journal،Vol. 2014, no. 2014, pp.1-8.
https://search.emarefa.net/detail/BIM-1048469
Modern Language Association (MLA)
Pellino, Gianluca& Selvaggi, Francesco. Surgical Treatment of Perianal Fistulizing Crohn’s Disease: From Lay-Open to Cell-Based Therapy—An Overview. The Scientific World Journal No. 2014 (2014), pp.1-8.
https://search.emarefa.net/detail/BIM-1048469
American Medical Association (AMA)
Pellino, Gianluca& Selvaggi, Francesco. Surgical Treatment of Perianal Fistulizing Crohn’s Disease: From Lay-Open to Cell-Based Therapy—An Overview. The Scientific World Journal. 2014. Vol. 2014, no. 2014, pp.1-8.
https://search.emarefa.net/detail/BIM-1048469
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1048469